Changes in risk factors and the decline in mortality from cardiovascular disease

Article Abstract:

Mortality due to cardiovascular disease has declined as much as 40 percent during the past 30 years, for reasons that remain unclear. Possible causes of the improvement are reduced incidence of disease, a reduced fatality rate, or better prevention and treatment. To better understand this positive trend, subjects originally enrolled in the Framingham Heart Study were evaluated. These people had been part of an initial group of 5,209 people who began the study between 1948 and 1952, and for whom complete medical records have been maintained. They comprised three male cohorts: men who were between 50 and 59 on January 1, 1950 (the 1950 cohort); those who were that age on January 1, 1960 (the 1960 cohort); and a 1970 cohort, as well. Their cardiovascular health during the ensuing decade after they entered each cohort was the subject of study. Cardiovascular disease, cerebrovascular disease (such as stroke), intermittent claudication (leg cramping and weakness due to poor circulation), and congestive heart failure (inadequate heart activity), were noted. Results showed a considerable increase in survival for the 1970 cohort as compared with the other two, with a reduction in mortality of 43 percent. This was not the result of reduced disease prevalence (which, in fact, increased between the 1950 and 1970 groups), but, rather, of reduced fatality from the disease. Nor did diagnoses become less severe for the 1970 cohort, as compared with the earlier groups; myocardial infarction, for instance, constituted approximately one third of all diagnoses for all cohorts. Risk factors, however, such as serum cholesterol level, smoking, and hypertension, improved between the 1950 and 1970 groups. Better medical treatment may be partly responsible to improved survival; however, since many treatments currently in use were not available to subjects in the earlier cohorts, their effects could not be studied. Overall, it is likely that improvements in risk factors were major contributors to the enhanced survival after cardiovascular disease in the last 30 years. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Statistics, Surveys, Risk factors (Health), Framingham Heart Study

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Number of pregnancies and the subsequent risk of cardiovascular disease

Article Abstract:

Being pregnant six or more times may increase the risk of cardiovascular disease or heart disease in women. Among 2,357 women aged 35 to 68, the average number of pregnancies was 2.3. After adjusting for age and level of education, the rate of cardiovascular disease was 1.6 times greater among women who had been pregnant six or more times than among women who had never been pregnant. This increased risk did not change even after adjusting for other known risk factors like elevated blood pressure and smoking. In a second study of 2,533 women aged 45 to 74, the average number of pregnancies was three. After adjusting for age and level of education, the rate of heart disease was 1.5 times greater among women who had been pregnant six or more times compared with women who had never been pregnant. Again, adjusting for other known risk factors did not alter the risk associated with being pregnant six or more times.

Health aspects, Pregnancy

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Multiple biomarkers for the prediction of first major cardiovascular events and death

Article Abstract:

The usefulness of ten previously reported biomarkers for predicting death and major cardiovascular events was evaluated in a large, community-based cohort. Results demonstrate that the use of contemporary biomarkers adds only moderately to standard risk factors for risk assessment of individual persons, which highlights the importance of evaluating putative biomarkers with the use of prospective data and explicit assessments of the ability to classify risk.

Science & research, Research, Diagnosis, Bronchoalveolar lavage, Clinical report

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